临床病例讨论——以躁狂发作为首发表现的异位促肾上腺皮质激素综合征  

Ectopic adrenocorticotropic hormone syndrome with manic attack as the first symptom

作　　者：贾晓凡[1] 鲜彤章[1] 潘琦[1] 王晓霞[1] 郭立新[1] Jia Xiaofan;Xian Tongzhang;Pan Qi;Wang Xiaoxia;Guo Lixin(Department of Endocrinology,Beijing Hospital,National Center of Gerontology,Beijing 100730,China)

机构地区：[1]北京医院内分泌科国家老年医学中心,100730

出　　处：《北京医学》2019年第4期306-309,共4页Beijing Medical Journal

摘　　要：目的分析异位促肾上腺皮质激素综合征(ectopic adrenocorticotropic hormone syndrome, EAS)的诊治思路,提高临床对EAS的诊治认识。方法分析北京医院内分泌科1例EAS患者的诊治经过及临床特点,并对相关文献进行总结。结果本例患者以躁狂发作为首发症状,合并高血压、顽固性低血钾等临床表现,定性诊断为库欣综合征(Cushing syndrome, CS),经影像学检查、岩下窦静脉取血、经皮肺穿刺等最终诊断为EAS。结论 EAS的临床表现不典型,易误诊、漏诊,本病的定位诊断较困难,需借助多种影像学方法以提高诊断率。Objective To analyze the process of diagnosis and treatment of ectopic adrenocorticotropic hormone syndrome(EAS)and improve clinicians'understanding of diagnosis and treatment of EAS.Methods The diagnosis,treatment and clinical characteristics of an EAS patient in the Department of Endocrinology of Beijing Hospital were analyzed,and the relevant literatures were summarized.Results The patient presented with mental disorders such as mania as the first symptom,combined with clinical manifestations such as hypertension and intractable hypokalemia which was finally diagnosed as EAS by imaging examination,IPSS,and percutaneous lung puncture.Conclusions The clinical manifestations of EAS are atypical,easy to be misdiagnosed and missed diagnosis.The localization diagnosis of this kind of diseases is difficult,so a variety of imaging methods are needed to improve the diagnosis rate of these diseases.

关 键 词：异位ACTH综合征 诊断 精神异常 

分 类 号：R586[医药卫生—内分泌]